Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Job Classification

In most duration tables, five job classifications are displayed. These job classifications are based on the amount of physical effort required to perform the work. The classifications correspond to the Strength Factor classifications described in the United States Department of Labor's Dictionary of Occupational Titles. The following definitions are quoted directly from that publication.

Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Breast Biopsy


Related Terms

  • Breast Cancer Detection
  • Breast Conservation Treatment

Specialists

  • General Surgeon

Comorbid Conditions

Factors Influencing Duration

The method of biopsy, including the amount of tissue removed, size of incision, type of anesthesia used, presence of complications, and individual's response to the procedure, will determine the length of disability. Individuals who have had an open biopsy will have a longer recovery time, depending on the extent of the surgery.

Medical Codes

ICD-9-CM:
85.11 - Closed [Percutaneous] [Needle] Biopsy of Breast
85.12 - Biopsy of Breast, Open

Overview

A breast biopsy is a method of obtaining tissue from a lump or other abnormality within the breast.

There are essentially two types of breast biopsies: needle biopsy and open or surgical biopsy. An open biopsy may remove either a sample of the lump (incisional biopsy) or the whole lump and surrounding tissue (excisional biopsy). If the whole lump or abnormality is removed, the procedure may also be called a lumpectomy. A needle biopsy uses a needle to remove a sample of tissue from the center of the lump (core biopsy). Small lumps may be removed in their entirety by needle biopsy. Stereotactic core biopsy uses breast x-ray (mammography) equipment and an automated biopsy gun to perform a needle biopsy.

Source: Medical Disability Advisor



Reason for Procedure

Breast biopsy is performed to collect tissue samples from a breast lump or other abnormality to determine if the lump is noncancerous (benign) or cancerous (malignant). Because about 30% of all lesions thought to be malignant are found to be benign upon biopsy, and about 15% thought to be benign are proven malignant, biopsy is the best way to test a breast lump so that treatment options can be explored.

Source: Medical Disability Advisor



How Procedure is Performed

Breast biopsies may be performed in a hospital, a mammography suite, or an operating room. Most biopsies are performed under local (surface and deep) anesthesia on an outpatient basis. A sedative may be required if the individual is particularly anxious about the procedure.

For breast lumps that cannot be felt (nonpalpable), imaging-guided breast biopsy may be performed. For this procedure, a fine needle or wire is guided into the lump by mammography or ultrasound localization to serve as a marker for the surgeon. A dye injection technique may be used alone or in conjunction with a needle or wire guide to mark the lesion. The needle is placed into the lump, and a dye is released as the needle is withdrawn, thereby leaving a visible track. Needle biopsies are most frequently used to obtain samples of suspicious, nonpalpable lesions that were identified by mammography. Needle biopsy is performed with either a large cutting needle (core needle biopsy) or a fine needle that sucks (aspirates) cells from the lump (fine-needle aspiration). Ultrasound may be used in conjunction with needle biopsies in order to visualize the needle path and the lump. With fine needle biopsy, standard office needles and syringes are used, and local anesthesia is not usually necessary. The needle penetrates the breast tissue and, while suction is applied, moves back and forth to sample several sites within the lump. Once enough tissue has been obtained, the needle is removed, and pressure is applied to the prick site to stop bleeding.

Core needle biopsy requires a small cut (incision) into which the biopsy needle is inserted. Slivers of breast tissue are obtained by applying suction with a syringe or vacuum-suction device.

Stereotactic core biopsy utilizes a mammography unit with the additional equipment necessary to perform a needle biopsy. For stereotactic core biopsy, the individual either sits upright or lies face down (prone) on a table so that the breast undergoing biopsy hangs down through a hole in the table. The breast is gently pressed between a plate (compression plate) and a platform (detector plate). The stereotactic equipment calculates the location of the lump and removes one or more samples using a needle or biopsy gun. Once a core biopsy needle is removed, pressure is applied to the wound to stop bleeding. This type of biopsy has lower complication rates and lower costs. This technique should not be used when the abnormality is very close to the chest wall or areola; in such cases, open biopsy is a better approach.

Open biopsies are recommended for older individuals because the risk of developing breast cancer increases with age, and a definitive diagnosis is essential.

Incisional biopsies are performed in cases of large masses, abnormalities consistent with inflammatory cancer, and other abnormalities for which conservation of the breast is not possible. Excisional biopsies can be performed on most breast lumps and have the advantage that, because the entire lump is removed, the diagnosis is definitive and the follow-up process is simplified (i.e., further treatment may not be necessary).

For open biopsies, the individual lies on his or her back, and a scalpel is used to cut into the breast to remove the entire lump or some part of it. Tissue from an open biopsy may be sent immediately to the pathologist so that, if indicated, additional tissue may be excised. Bleeding is controlled using electricity, a laser BEAM (cautery), or fine stitches (sutures). The incision is sutured closed with care so that scarring is minimal.

A cytologist or cytopathologist analyzes tissue obtained by fine needle aspiration. A pathologist analyzes other biopsy samples.

Source: Medical Disability Advisor



Prognosis

Most biopsy procedures successfully sample the breast lump. Up to 18% of needle biopsies must be repeated because of a disagreement between imaging studies and the biopsy findings, inadequate tissue sampling, or a need for a broader sample. However, needle biopsies are less invasive, less traumatic, and result in a quicker recovery than open biopsies. The results of 80% of breast biopsies are benign ("Breast Biopsy").

Following a needle biopsy, individuals can return to normal activities almost immediately.

Source: Medical Disability Advisor



Complications

Fine needle aspirations are rarely complicated. Core needle biopsies can cause bleeding (hemorrhage) and blood accumulation within breast tissue (hematoma). Complications associated with open breast biopsy include hemorrhage, hematoma, infection, black-and-blue marks beneath the skin (ecchymoses), numbness, and prickling or burning sensations (paresthesias). There will be a small scar. An interference with breast feeding can occur following breast biopsy near or beneath the nipple. Guide wires may break or be cut during surgery and can remain stable or migrate to other parts of the body.

Source: Medical Disability Advisor



Ability to Work (Return to Work Considerations)

Strenuous activities (especially lifting or reaching overhead) may be restricted if an open excision is performed. For a few days following the biopsy, the individual may need to apply an ice pack to the breast several times a day and thus may require more frequent rest breaks.

Source: Medical Disability Advisor



References

Cited

"Breast Biopsy." MedicineNet.com. MedicineNet, Inc. 16 Sep. 2004 <http://www.medicinenet.com/breast_biopsy/page1.htm>.

Source: Medical Disability Advisor






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